Precision Surgery for Pediatric Hydrocephalus: VPS vs. ETV With ML-Guided Prediction

NCT ID: NCT07330206

Last Updated: 2026-01-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

800 participants

Study Classification

OBSERVATIONAL

Study Start Date

2016-01-01

Study Completion Date

2024-01-20

Brief Summary

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Study type: Multicenter retrospective cohort study with prospective validation Primary purpose: To determine whether an individualized, imaging-guided treatment algorithm Ventriculoperitoneal shunt (VPS) vs endoscopic third ventriculostomy (ETV) improves 2-year neurodevelopmental outcomes in children \<18 y with congenital hydrocephalus.

Main questions

* Does ETV produce higher 6-month surgical success and lower 2-year re-intervention rates than VPS in prespecified subgroups (age ≥3 y, obstructive hydrocephalus, normal basal cisterns)?
* Does a machine-learning model (ETV-PS) using pre-operative MRI features accurately predict ETV success (AUC ≥0.80) and thereby reduce unnecessary re-operations?
* Does early, frequent programmable-valve pressure adjustment after VPS decrease over-shunting headaches and improve 2-year cognitive scores compared with standard, infrequent adjustment?

Comparison: ETV group vs. VPS group (1:1 propensity-matched); within VPS cohort, frequent (≥3 adjustments in first 6 mo) vs. infrequent (\<3) pressure-tuning arms.

Participants will

* Provide pre-operative clinical data and MRI/CT imaging.
* Undergo either VPS or ETV as clinically indicated; 320 VPS recipients receive programmable valves with protocol-driven pressure logs.
* Return for standardized neurodevelopmental testing Children's Memory Scale (CMS), Wechsler Intelligence Scale for Children(WISC), Pediatric Quality of Life Inventory(PedsQL) and imaging at 6 mo, 1 y and 2 y; valve adjustments tracked electronically.

Detailed Description

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Conditions

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Hydrocephalus in Children

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

RETROSPECTIVE

Study Groups

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ETV group

All undergo endoscopic third ventriculostomy as initial treatment

MRI-Guided Precision Shunt or ETV Strategy

Intervention Type DIAGNOSTIC_TEST

VPS group

* 320 receive a programmable valve with protocol-driven pressure adjustments
* 80 receive a fixed-pressure valve (included only in VPS-vs-ETV comparisons, excluded from valve-management sub-analysis)

MRI-Guided Precision Shunt or ETV Strategy

Intervention Type DIAGNOSTIC_TEST

Interventions

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MRI-Guided Precision Shunt or ETV Strategy

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Age 0-17.99 years at surgery
* Congenital hydrocephalus confirmed by clinical and MRI/CT findings
* First surgical treatment: either VPS or ETV
* Complete pre-operative MRI/CT and ≥ 2-year follow-up data available

Exclusion Criteria

* Secondary hydrocephalus (tumor, infection, trauma)
* Severe comorbidities affecting neuro-developmental assessment (e.g., major congenital heart disease, genetic-metabolic disorders)
* Incomplete baseline imaging or follow-up \< 2 years
Maximum Eligible Age

17 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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West China Hospital

OTHER

Sponsor Role lead

Responsible Party

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Zhigang Lan

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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West China Hospital of Sichuan University

Chengdu, Sichuan, China

Site Status

Countries

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China

Other Identifiers

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WestChinaH-HX-2025-011

Identifier Type: -

Identifier Source: org_study_id

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